Being a parent to a child suffering from tics can be stressful. Children with tics need support and positive guidance to help them adapt to the disorder. Early identification and proper education will improve symptoms and prevent psychological damage. 

Understanding Tics

Tics are repeated rapid movements or sounds. The twitches are involuntary and can involve any muscle group. They are quick, uncontrollable, and typically involve the eyes, face, neck, and shoulders. The most commonly observed tics are eye blinking, facial grimacing, head jerking, shoulder shrugging, throat clearing, sniffing, coughing, and grunting. Even though a child experiencing a tic is fully alert, he has no control over the movements or sounds. The intensity of tics fluctuates, and they usually worsen if the person is stressed, tired, or anxious. They stop when a person is asleep or engaged in an inactive activity such as watching television.

Tics are caused by extreme stress, medications and other brain stimulants, bacterial or viral infections involving the brain, and genetic or metabolic disorders that affect the brain. Children with tics often have underlying learning disabilities such as attention deficit hyperactivity disorder (ADHD).

Tics can be vocal or motor and simple or complex. Simple motor tics usually include eye blinks and muscle twitches. A complex motor tic may involve a muscle movement like scratching, throwing, or chewing.

Simple vocal tics include throat clearing, sniffing, coughing, or grunting. A person with a vocal complex tic may say words, usually in an explosive and spastic fashion. A person with ticks may repeat words or phrases, or have swearing outbursts.

Tourette syndrome is a genetic tic disorder with symptoms that usually begin before age 18. People who have Tourette syndrome may also have obsessive-compulsive behavior and attention deficit hyperactivity disorder. The disease is characterized by the presence of repetitive muscle movements and vocal outbursts. Different tics can occur simultaneously in this condition.

In Tourette syndrome, tics are present for over one year and occur frequently. Other tics tend to resolve within several months. The tics can cause marked distress and impair work and social or personal functioning. Fortunately, most children with simple tics do not develop Tourette syndrome because Tourette is a genetic condition.

The situation needs to be handled sensitively and supportively by assuring the child nothing is wrong with him or her, and there is no reason to be ashamed of the tics. It does not help to scold a child suffering from tics or call attention to the unusual mannerisms. Punishment by parents, teasing by classmates, and scolding by teachers will not help tics and could make matters worse.

Parents need to find ways to decrease stress and conflict in the child’s life and should try to identify the cause of tics. It is important to figure out if a medication is triggering the tics, such as decongestants, stimulant drugs used to improve attention span, or anticonvulsants.

Treatment

Treatment for simple tics and Tourette syndrome is similar. There are no specific diagnostic tests for either disorder. Treatment of tics depends on the severity of the condition, duration of the symptoms, distress it causes the patient, and effect it has on school or job performance. In a majority of children, simple tics resolve spontaneously within several months and do not require treatment. However, the tics associated with Tourette syndrome are longer lasting, although they tend to get milder or go away entirely as children reach adulthood.

Treatments like behavioral therapy, medication, and more intensive psychotherapy are used for tics that interfere with a child’s progress in school, social development, outside activities, or family relationships. In behavioral therapy, people learn to manage their tic symptoms and reduce their frequency.

Medications may also be prescribed to help reduce the frequency of symptoms, but they cannot make the tics disappear completely.

In a majority of children, tics are mild and do not interfere with daily functioning. Symptoms of tics usually develop between the ages of 6 and 8 and may last for four to six years. The symptoms usually disappear in early adolescence. Time typically takes care of simple tics and treatment is not required. Severe tics caused by Tourette syndrome tend to get milder and can disappear between the ages of 20 and 24, but full remission is uncommon.

Families of children suffering from tics should make an extra effort to promote understanding and tolerance within the child’s environment. This can lead to quicker improvement. While some tics may signify the presence of learning disabilities, simple motor tics and tics caused by Tourette syndrome do not cause intellectual problems.